Impact Assessment of the Community Animal Health System in ...

3.5 Areas for improvement
Table 6 describes some of the limitations of the CAH system identified by stakeholders, how these
limitations affected the performance of the program, and suggestions for improvements or better
options for future interventions. The Table summarizes comments by stakeholders including
beneficiaries, CAHWs, private veterinary practitioners, VSF Suisse staff and the members of the
assessment team.
Table 6. Stakeholder review of CAH system
Limitations
VSF Suisse has not been effectively utilizing
information from CAHWs monthly treatments
reports to provide on‐the‐ job training to them.
Therefore, some of the CAHWs had some
knowledge gaps:
using antibiotic drugs against some untreatable
diseases;
administering dihydrostreptomycin tablets
orally to adult ruminants;
knowledge gaps on camel diseases.
VSF Suisse worked with only eight CAHWs out of
around 16 CAHWs that used the private veterinary
pharmacies:
the coverage of the CAHWs service was very
poor;
consequently, pastoralists continued using lowquality
drugs from ordinary shops and blackmarket
dealers, as well as using incorrect
treatment procedures such as administering
penicillin‐streptomycin by intravenous
injection.
The private pharmacies were selling highquality
drugs from the European company
Norbrook Ireland.
They sold short‐acting antibiotic drugs such as
10% oxytetracycline, Penstrep, Deseptoprim
tablets and Tylosin together with 20% long
acting oxytetracycline, and this has technical
problems.
The pharmacies were forced to follow
pastoralists’ preference for short‐acting drugs
partly due to the lower price 11 .
The presence of the donor and VSF Suisse logos on
the wall of the pharmacies meant that the
communities and some of the CAHWs thought that
the pharmacies were selling donated (free) drugs at
commercial prices to make a profit; this affected the
normal client relationships to some extent.
Suggestions
Train VSF and government staff on
participatory monitoring techniques as part of
their CAHW training‐of‐trainers course;
Further training for all CAHWs by experienced
veterinarian focusing on camel health
problems and treatments, particularly correct
use of antibiotics.
Include the other CAHWs in future refresher
training;
Train additional CAHWs on cost sharing basis.
The CAHWs need to cover the kit cost and this
requires the community to look for better‐off
members during selection 10 .
Strong training for private practitioners on
drug prescription and handling matters.
Mass education on drug‐ related issues to
pastoralists.
Erase the logos and make all stakeholders
aware that the drugs in the pharmacies are
purely private property.
10 The members of the communities involved in this assessment suggested that any additional CAHWs trained may need to
cover the kit cost especially of veterinary drugs.
11 There seems to be limited justification for selling 10% oxytetracycline to CAHWs.
11